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The clavicle is commonly known as the collarbone and is one of the most commonly fractured bones in the shoulder girdle. When this fracture happens in children before they are finished growing, it can almost always be treated in a simple sling and not only will it heal but it will also remodel and eventually look like normal. If this fracture happens in an adult who needs to maintain normal overhead strength, I tend to recommend surgery if there is no contact between the two bone fragments, if there is a significant shortening of the clavicle compared to the other side that forces the shoulder to shift forward, or if the fracture does not heal and continues to be painful.
The classic form of fracture fixation with a plate and screws works well for many clavicle fractures, but because the bone is right underneath the skin the plate can sometimes be painful, especially if you are used to wearing a backpack or anything heavy directly over the collarbone. If the fracture is simple enough and surgery is warranted, I like to consider using the Accumed Dual-Trak Screw, which I learned how to do from a colleague of mine who has done a large series of patients with this implant.
Frequently Asked Questions
How do I know if I need surgery for my clavicle fracture? There is such a great variability in how the clavicle can break that it is impossible to give a blanket statement that covers all the different types of fractures and their subtypes. I am happy to see you in the office any time or even virtually through our telemedicine virtual portal, and as long as I am able to see pictures of your xray I will be able to advise you on whether it would be worth considering surgery for your fracture.
Will my shoulder feel like it is back to normal? One of the surprising things about clavicle fractures is that they do not necessarily have to heal in order for the function of the shoulder to go back fairly close to normal. If the fracture doesn't heal we call that a nonunion, but it is just as possible to have a functional nonunion as it is to have a painful, nonfunctional nonunion. Every fracture has to be treated on a case by case basis, avoiding surgery whenever possible, but most people tend to do reasonably well overall and recover almost completely from their clavicle fractures.